Navegando por Palavras-chave "Hepatitis Autoimmune"

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    Prevalência de manifestações dermatológicas em pacientes com diagnóstico de Hepatite autoimune
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-02) Souza, Nivea Godinho Alves De [UNIFESP]; Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The presence of extrahepatic manifestations, involving multiple systems, is well known in hepatobiliary diseases. There are several studies that correlate dermatological findings with liver diseases, but the real prevalence of these manifestations in patients with autoimmune hepatitis (HAI) is not yet known. The present study aimed to verify the dermatological manifestations in patients with AIH and to relate them to clinical, laboratory and histopathological manifestations of the disease. The study was cross-sectional observational. From October 2016 to July 2017, patients with previous diagnosis of HAI were consecutively selected for dermatological evaluation after consultation with the medical team of the UNIFESP / EPM Hepatitis Outpatient Clinic. A total of 111 patients with AIH were included, with a mean age of 44.2 ± 17.5 years and 90.1% female. HAI type 1 was the most common (93.7%) followed by type 2 (6.3%). Regarding treatment, 3.6% were off medication due to remission of the disease, 58.5% were using dual therapy with prednisone + azathioprine, 6.3% were dual therapy with prednisone + mycophenolate mofetil and 31.5% azathioprine alone. In the biochemical and pathological analysis, at the time of diagnosis, high mean AST (354 IU / L) and ALT (392 IU / L) values were observed and more than 50% of the patients had advanced fibrosis (grades 3/4). with liver cirrhosis rates of 37.7%. The prevalence of very significant dermatological manifestations was 11.7%, the most frequent being: vitiligo 2.7%, urticaria 2.7%, lichen planus 1.8% and chronic cutaneous lupus 1.8%. Manifestations considered significant were observed in 95.5% of the patients: fungal infections (51.3%), seborrheic dermatitis (42.3%), vascular alterations (35.1%), melasma (26.1%), acne ( 22.8%), eczematous diseases (21.8%) and telogen effluvium (15.3%). Minor manifestations were observed in 89.2%: benign neoplasia (67.5%), photodermatoses (50.4%) xerosis (29.7%) and stria violaceous (18.9%). In patients with very significant dermatological manifestations, when compared to the others, there was a higher frequency of associated autoimmune disease (46.2 vs 21.4% p = 0.001) and lower prothrombin activity (55 vs 72% p = 0.0001). . In conclusion, in this study of dermatological manifestations in patients with AIH, a high prevalence of skin alterations was observed, more frequently then those observed for the general population in the literature. Early recognition of these manifestations in the context of patients with AIH may be fundamental for the better xv management of these patients, as such alterations may be the first step to allow the diagnosis of liver disease.